de Bairros André Valle, de Vargas Paier Karol Andriely, Cardoso Leonardo Corrêa, Reginato Fernanda Ziegler, Ugalde Gustavo Andrade, Lovatel Ivy Bauer, Roehrs Miguel
Nucleus Applied to Toxicology, Federal University of Santa Maria, Santa Maria, Brazil.
University Hospital of Santa Maria, Federal University of Santa Maria, Santa Maria, Brazil.
Toxicol Rep. 2025 Jan 4;14:101891. doi: 10.1016/j.toxrep.2025.101891. eCollection 2025 Jun.
Valproic acid (VPA) is an anticonvulsant widely used in treating epilepsy which can occur cases of poisoning in overdose situations.
A 15-year-old girl purposely ingested about 100 drug tablets according to family members. Gastric lavage with activated charcoal was performed at home using a nasogastric tube and patient just was taken to the hospital around 10 h after drug ingestion, arriving in shock state. All laboratorial parameters were altered together a suspect of aspiration pneumonia with the presence of gross perihilar infiltrated in the right lung. Immunoassay screening test did not detect any substance; LC-UV detected quetiapine (> 150 ng/mL) while GC-MS determined 977.96 µg/mL of valproic acid in the patient's plasma, confirming valproic acid intoxication. Appropriate life support was performed in the patient during hospitalization; however, she died two days later, reaching her suicide.
Prognosis could be favorable if the patient was taken immediately to hospital emergency, considering the complexity of managing poisoning. Patient´s anamnesis must be carefully analyzed by the healthcare professional to avoid false conclusions and toxicological analysis is extremely important to clarify suspected poisoning.
丙戊酸（VPA）是一种广泛用于治疗癫痫的抗惊厥药物，在过量使用时可能会发生中毒病例。
据家人称，一名15岁女孩故意服用了约100片药物。在家中使用鼻胃管进行了活性炭洗胃，患者在服药约10小时后才被送往医院，到达时处于休克状态。所有实验室参数均发生改变，同时怀疑有吸入性肺炎，右肺门周围有明显浸润。免疫分析筛查试验未检测到任何物质；液相色谱-紫外检测法检测到喹硫平（>150 ng/mL），而气相色谱-质谱法测定患者血浆中丙戊酸含量为977.96 μg/mL，证实为丙戊酸中毒。患者住院期间进行了适当的生命支持；然而，她两天后死亡，死于自杀。
考虑到中毒处理的复杂性，如果患者立即被送往医院急诊，预后可能良好。医护人员必须仔细分析患者的病史，以避免得出错误结论，毒理学分析对于明确可疑中毒极为重要。
